Experts call for urgent action on global diabetes epidemic

By Nilima Marshall, PA Science Reporter

Health experts are calling for urgent action to address the global diabetes epidemic as Covid-19 continues to highlight the vulnerability of people with the condition.

Ahead of World Diabetes Day on November 14, a team of 44 leading experts from around the world have published a report in the journal Lancet, saying a lack of evidence-based interventions is “leading to thousands of preventable deaths globally daily”.

Diabetes caused 4.2 million deaths globally in 2019, according to figures from the International Diabetes Federation.

Around 463 million people worldwide are thought to have diabetes, with 3.9 million people living with the condition in the UK.

In Gibraltar, over 3,000 people have diabetes.

According to experts, diabetes reduces life expectancy in middle-aged people by four to 10 years and independently increases the risk of death from cardiovascular disease, kidney disease, and cancer by up to three times.

Data from research on Covid-19 suggests people with diabetes have at least two times the increased risk of severe disease or death from Covid-19.

Lead author Professor Juliana Chan, from The Chinese University of Hong Kong, said: “By protecting our environment, changing our practice, and empowering our communities, we can reduce the burden of diabetes as a root cause of many noncommunicable diseases (NCDs).

“The diabetes epidemic is a calling that concerns all of us, as everyone has contributed to the ecosystem in one way or another to fuel the epidemic.

“As such, we all have the collective responsibility to rise to this challenge to sustain our environment and to use our finite resources wisely to preserve humanity.

“The global challenge of diabetes transcends political, economic, social, and technological domains.”

While effective treatments and prevention strategies exist for diabetes, the experts said barriers to provision and access mean that their use is scarce in most care settings.

As part of the Lancet Commission on Diabetes, the team has put together the best evidence for effectively managing diabetes.

These include a sustained weight reduction in patients with obesity by 15kg or more – which can induce remission of type 2 diabetes for up to two years.

Other recommendations include reducing blood sugar levels by 0.9%, systolic blood pressure by 10 mm Hg and LDL or “bad” cholesterol concentration by 1 mmol/L – which can independently reduce the risk of cardiovascular disease in patients with type 2 diabetes.

The experts also said that implementing a structured lifestyle intervention and use of the diabetes drug metformin can each prevent or delay type 2 diabetes in individuals with impaired glucose tolerance by 30% to 50%.

Writing in a linked comment, Katie Dain, of NCD Alliance in Switzerland, said: “We must collectively call on political leaders and governments to make good on their UN commitments with decisive, inclusive, and accountable leadership and appropriate investment if we are to reach the 2025 NCD targets.”

She added: “Irrespective of the challenging financial landscape, investment in tackling diabetes and other NCDs now will prevent substantial and unsustainable healthcare costs in the future.”